1. About felodipine
Felodipine is a medicine used to treat high blood pressure.
Felodipine is also used to prevent angina (chest pain caused by heart disease).
This medicine is only available on prescription. It comes as tablets.
2. Key facts
- Felodipine lowers your blood pressure and makes it easier for your heart to pump blood around your body.
- It's usual to take felodipine once a day in the morning.
- Do not eat grapefruit or drink grapefruit juice while you're taking felodipine. Grapefruit can make side effects worse.
- Felodipine is also called by various brand names, including Plendil, Cardioplen XL, Folpik XL, Vascalpha and Neofel XL.
3. Who can and cannot take felodipine
Adults aged 18 and over can take felodipine.
Felodipine isn't suitable for some people.
To make sure felodipine is safe for you, tell your doctor if you:
- have had an allergic reaction to felodipine or any other medicine in the past
- are trying to get pregnant, are already pregnant or if you are breastfeeding
- have heart failure or heart disease or you've recently had a heart attack
- have new chest pain or chest pain that lasts longer or is more severe than usual
- have liver problems
4. How and when to take
Take felodipine as your doctor has told you, and follow the directions on the label. If you're not sure, check with your doctor or pharmacist.
Felodipine comes as "prolonged release" tablets (sometimes called "modified release"). This means that the tablets release felodipine slowly and evenly throughout the day.
How much to take
Your dose of felodipine depends on why you need the medicine. To decide the correct dose for you, your doctor will check your blood pressure.
Elderly patients usually start on a lower dose of 2.5mg once a day.
Will my dose go up or down?
If the starting dose isn't working well enough, your doctor may increase it to 10mg a day.
If you have side effects or your blood pressure goes too low, your doctor may lower your dose to 2.5mg a day.
How to take it
It's usual to take felodipine once a day in the morning. It's best to take it on an empty stomach or after a light meal or snack that isn't too fatty or starchy.
Swallow the tablets whole with a glass of water. Do not break, crush or chew them. Talk to your pharmacist or doctor if you have problems swallowing them.
Do not eat or drink grapefruit or grapefruit juice while you're taking this medicine. Grapefruit juice can make side effects worse.
Take felodipine even if you feel well, as you will still be getting the benefits of the medicine.
What if I forget to take it?
If you forget a dose of felodipine, just take your next dose at the usual time. Do not take a double dose to make up for a forgotten one.
If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
What if I take too much?
If you take too much felodipine by accident, contact your doctor or go to your nearest hospital straight away.
An overdose of felodipine can cause dizziness and make you feel sick and sleepy.
The amount of felodipine that can lead to an overdose varies from person to person.
Urgent advice: Call your doctor or go to A&E straight away if:
- you take too much felodipine
If you need to go to a hospital accident and emergency (A&E) department, do not drive yourself - get someone else to drive you or call for an ambulance.
Take the felodipine box, or the leaflet inside the packet, plus any remaining medicine with you.
5. Side effects
Like all medicines, felodipine can cause side effects, although not everyone gets them. Side effects often improve as your body gets used to the medicine.
Common side effects
These common side effects happen in more than 1 in 100 people. They are usually mild and short-lived.
Talk to your doctor or pharmacist if the side effects bother you or last for more than a few days:
- flushing (feeling hot)
- a pounding heartbeat
- swollen ankles
Serious side effects
Serious side effects are rare and happen in less than 1 in 1,000 people.
Stop taking the medicine and call a doctor straight away if you get chest pain that is new or worse. This side effect needs to be checked out as chest pain is a possible symptom of a heart attack.
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to felodipine.
Immediate action required: Call 999 or go to A&E now if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of felodipine. For a full list see the leaflet inside your medicines packet.
You can report any suspected side effect using the Yellow Card safety scheme.
6. How to cope with side effects
What to do about:
- headaches - make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches should usually go away after the first week of taking felodipine. Talk to your doctor if they last longer than a week or are severe.
- feeling dizzy - if felodipine makes you feel dizzy, stop what you're doing and sit or lie down until you feel better.
- flushing - try cutting down on coffee, tea and alcohol. It might help to keep the room cool and use a fan. You could also spray your face with cool water, or sip cold or iced drinks. The flushing should go away after a few days. If it doesn't go away, or if it's causing you problems, contact your doctor.
- swollen ankles - raise your legs while you're sitting down.
7. Pregnancy and breastfeeding
Felodipine is not recommended in pregnancy or when breastfeeding.
If you're trying to get pregnant or you're already pregnant, talk to your doctor about the benefits and possible harms of taking felodipine. There are usually other medicines that are safer for you.
Felodipine and breastfeeding
Small amounts of felodipine may get into breast milk, but it's not known if this is harmful to the baby. Talk to your doctor as other medicines might be better while you're breastfeeding.
Non-urgent advice: Tell your doctor if you're:
- trying to get pregnant
8. Cautions with other medicines
If you take other medicines that lower blood pressure with felodipine, the combination can sometimes lower your blood pressure too much. This may make you feel dizzy or faint. If this keeps happening to you, tell your doctor as your dose may need to be changed.
Some medicines can interfere with the way felodipine works.
Tell your doctor if you're taking any of these medicines before starting felodipine:
- anti-epilepsy medicines: carbamazepine, phenytoin, phenobarbital (phenobarbitone) or primidone
- antibiotics: clarithromycin, erythromycin or rifampicin
- the antifungal itraconazole
- medicines for HIV or hepatitis C virus
- medicines to reduce immune reactions such as ciclosporin or tacrolimus
Mixing felodipine with herbal remedies or supplements
St John's wort, a herbal medicine taken for depression, is thought to interfere with the way felodipine works. Talk to your doctor if you're thinking about taking St John's wort.
Important: Medicine safety
Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.
9. Common questions
How does felodipine work?
Felodipine is a type of medicine called a calcium channel blocker.
Like other calcium channel blockers, it relaxes and widens blood vessels. It does this by blocking calcium going into muscles in the heart and blood vessels. Muscles need calcium to contract, so when you block the calcium, it makes the muscle cells relax. This lowers your blood pressure and makes it easier for your heart to pump blood around your body.
In angina, felodipine works by improving the blood supply to your heart. Angina is chest pain that comes on when not enough blood gets to the muscles of the heart. It usually happens because the arteries to the heart have become hardened and narrowed.
Felodipine widens the arteries so more oxygen gets to the heart which prevents chest pain.
How long does felodipine take to work?
Felodipine starts to work on the day you start taking it, but it may take a couple of weeks for you to feel the full effect.
If you're taking felodipine for high blood pressure, you may not have any symptoms. In this case, you may not feel any different when you take it. This does not mean that the medicine isn't working and it is important to keep taking it. Your doctor will check to see how well it is working.
If you're taking felodipine for angina, it will probably take a couple of weeks before you feel better. Until then, you'll still get chest pain. Make sure you have your medicine (spray or tablets) for treating angina attacks with you at all times, and use it if you need to. Keep taking felodipine every day and you should have fewer attacks within a couple of weeks. Talk to your doctor if your chest pain (angina) does not get any better after a couple of weeks. If it gets worse (happens more often or is more severe) tell your doctor immediately.
How long will I take it for?
Usually, treatment with felodipine is long term, even for the rest of your life.
Is felodipine safe to take for a long time?
Felodipine is generally safe to take for a long time. In fact, it works best when you take it for a long time.
Can I come off felodipine now my blood pressure is lower?
Even if felodipine lowers your blood pressure successfully, it's best to carry on taking it. If you stop taking felodipine, your blood pressure could rise back up again.
If you are taking felodipine for angina, stopping it will increase your chances of having more angina attacks.
If you need medicines to lower your blood pressure, you'll probably need to take them for the rest of your life.
Remember, by keeping your blood pressure low, you're protecting yourself against having a heart attack or stroke in the future.
What will happen if I stop taking it?
Talk to your doctor if you want to stop taking felodipine.
Stopping felodipine may cause your blood pressure to rise - and this may increase your risk of heart attack and stroke.
If you are taking it for angina, stopping it will make it more likely you will have more angina attacks.
If you're bothered by side effects, your doctor may be able to prescribe you a different medicine.
Can I drink alcohol with it?
Yes, you can drink alcohol with felodipine. However, drinking alcohol can increase the blood pressure-lowering effect of felodipine, which can make you feel dizzy or light-headed. If this happens to you, it's best to stop drinking alcohol while you're taking it.
Are there similar medicines to felodipine?
For high blood pressure
There are also lots of other types of medicines to lower your blood pressure. They work in a different way to calcium channel blockers and include:
- ACE inhibitors - for example ramipril and lisinopril
- angiotensin receptor blockers - for example candesartan
- beta blockers - for example bisoprolol
- medicines that make you pee more (diuretics) - for example bendroflumethiazide
If you can't take felodipine or other calcium channel blockers because of side effects, you may be able to switch to another medicine. Your doctor will advise which one is best for you depending on your age, ethnicity and medical history.
There are other calcium channel blockers, such as diltiazem and verapamil, which are used for angina. There are also other medicines for angina which work in a different way. They include:
- beta blockers - for example bisoprolol
- nitrates - for example isosorbide dinitrate
Is felodipine addictive?
No, there's no evidence that felodipine is addictive.
Will it affect my contraception?
Will it affect my fertility?
There's no firm evidence to suggest that taking felodipine will reduce fertility in either men or women.
However, speak to a pharmacist or your doctor before taking it if you're trying to get pregnant.
Is there any food or drink I need to avoid?
Do not eat grapefruit or drink grapefruit juice. Grapefruit can make the side effects of felodipine worse.
Otherwise, you can eat and drink normally while taking felodipine.
Can I drive or ride a bike?
Felodipine can make some people feel dizzy. If this happens to you, do not drive a car, ride a bike, or use tools or machinery until you feel better.
Can lifestyle changes help?
- Quit smoking - smoking increases your heart rate and blood pressure. Quitting smoking brings down your blood pressure and relieves heart failure symptoms. Try to avoid secondhand smoke.
- Cut down on alcohol - drinking too much alcohol raises blood pressure over time and also makes heart failure worse. Men and women shouldn't drink more than 14 units of alcohol a week. A standard glass of wine (175ml) is 2 units. A pint of lager or beer is usually 2 to 3 units of alcohol.
- Exercise - regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. It doesn't need to be too energetic - walking every day will help.
- Eat well - aim to eat a diet that includes plenty of fruit and veg, wholegrains, fat-free or low-fat dairy products and lean proteins. It's a good idea to cut down on salt too. Eating too much salt is the biggest cause of high blood pressure - the more salt you eat, the higher your blood pressure will be. Aim for no more than 6g of salt a day.
- Deal with stress - when you're anxious or upset, your heart beats faster, you breathe more heavily and your blood pressure often goes up. This can make heart failure worse too. Find ways to reduce stress in your life. To give your heart a rest, try napping or putting your feet up when possible. Spend time with friends and family to be social and help avoid stress.
- Vaccinations - if you have heart failure, it's recommended that you have a flu jab every year and a pneumonia vaccination (also known as the pneumococcal vaccine) every 5 years. Ask your doctor about these vaccinations. You can have them free on the NHS.